Toddler Throws up Only at Bedtime- Help!

Your kid waited until he was two to start throwing up when he doesn't want to do something? Or, more to the point, wants YOU to do something?
I don't mean to make light, but that's one of the oldest tricks in the book. Even kids younger figure out if they stick their fingers in their mouth far enough, they will gag or throw up and Mommy comes running.
Cause and effect.
I've known little kids that have thrown up at hearing the word broccoli.
Because they don't want to eat it.
It's hard to believe that a precious child can be that manipulative, but they can. And, in all fairness, they don't have the capability to pre-determine a manipulative behavior. They do something, they get a reaction that is pleasing or beneficial to them in some way and they learn what works to continue getting it. So that's what they do.
Your two year old thinks HIS bedtime is YOUR bedtime.
He is two. You are not.
He does not determine when you go to sleep or lay down and he also should't determine where you do it.
Deal with the constipation issues.
But, that has nothing to do with the fact your son is fine all day long until it's time for him to go to bed. All by himself.
He doesn't have the flu. He's not sick or he'd be barfing all day long.
It really is my guess that he knows if he throws up, he can drag out bedtime and you will lay down with him or whatever because our babies throwing up is so horrible.
It's not horrible for them if it serves a purpose.
Try not racing to him or even responding to it.
He does it when you try to leave the bedroom?
Just leave anyway.
"Good night! I love you!"
Close the door.
If he's throwing up in YOUR bed, I'd say it's time for him to have his own.
He can throw up in his own bed as much as he wants, but he's still going to bed. When you say. And YOU don't have to go to bed with him at the same time.
His life will not end because of it. It really won't. You're not being cruel by letting him realize that.

You are obviously a very loving and affectionate mother.

You know nothing is harming your son by having bedtime.

Hang in there and be strong.
It's just my opinion, but the sooner you get him to sleep by himself, the sooner you will both be happy in the evenings.

Best wishes.

So what do you do when this happens? Does he get his way? If you show lots of concern and he gets what he wants this way, it works for him and it will continue and perhaps escalate.

Throwing up is so hard on most adults. It hurts and makes us feel awful. But it's easy for kids. We think "omg, my kid is throwing up" but if they aren't sick and it's a way of gaining control of some kind, it's not hard on them.

I would approach this two ways. First, I'd handle the constipation first. He needs lots of fiber and fluids to help him have more normal bowel movements. Then I would have easy to digest dinners for a while, and put forth a concerted effort to institute a bedtime routine that stays the same. Even if that means putting your foot down about bedtimes rules and allowing him to throw up. Don't talk about it, just let him throw up, put on his pj's when he's done, and tell him good night.

After he sees it doesn't work anymore, the throwing up should taper off. As you handle the constipation, offer him a better diet so that he is not as apt to get constipated - he should start eating more once he's feeling better in his belly. Don't push him to eat. You don't want him to use food to get what he wants from you. If he thinks that you will give him more leeway when he eats more and then throws it up, you will defeat your purpose working with him.

And you shouldn't have to go to bed with him to do this, M.. You have to lovingly assert your authority here. You are the adult, he is the child.

All my best,
Dawn

The 'stress' that the child feels can trigger an adrenaline increase. High adrenaline can trigger nausea and vomiting. Does he get shakey? Chilled, or cold skin to the touch? Sensitive to lights and noise? Any migraines? have you asked him if he is feeling nausea during the day or evening?

I think there is an affect on his HPA axis . I'm not sure what exactly though. This article that I attached mentions that fludrocortisone and beta blockers can help this condition. Fludrocortisone is a cortisol replacement. So if fludrocortisone works for him, then his cortisol is low. Cortisol is used by the body to increase blood sugar. If there is not enough cortisol available, the body uses adrenaline to bring up blood sugar. That might a reason why adrenaline would already be running high in his body. A good start for a test would be a cortisol saliva test (not the blood test). Electrolytes should also be tested. Now, if he is vomiting then his electrolytes will already be off. He needs something like pedialyte to restore those electrolytes or else damage to the system can occur. The body MUST have proper electroyte balance for life.

The other possiblity is that the child may have an adrenal tumor like a pheochromocytoma, that is putting out high amounts of adrenaline. When the child gets stressed or excited, it will trigger a large release of adrenaline resulting in either siezures or vomiting. Testing for this would be measuring catecholamines in plasma/24 hr urine,and measure metanephrine in blood.

http://emedicine.medscape.com/article/933135-overview

I think you need to do some more investigating, but a standard medical doctor isn't going to have a clue about this cyclical vomiting condition. You may need an endocrinologist and even many of those may not want to help. You are going to have to do much research on your own and keep pushing for answers. Be relentless and don't let them blow you off. IF your docotr wont give him a saliva cortisol test, bypass him and order it yourself through canaryclub.org. Email me to help you with deciphering the test results.

A clue that this is not just a "mental" condition is the fact that his appetite had dropped. I have learned after many years, always give the child the benefit of the doubt.

Hang in there ,
Gail

Did you suddenly stop co-sleeping with him at his bedtime? That may be the stressor that is causing him to try and show you how upset it's getting him when you aren't there like you usually would be.

Was the vomit more foul smelling than vomit usually is?

I baby sat a poodle once that did pretty much the same thing. When she felt she was not getting enough attention, she's lap up all the water in her dish then barf. Solution? I just started filing her bowl half way and check if frequently. She could never get enough at one go to get a good barf session going.
For your son, try moving his meal time so that his stomach will be more empty at bed time.